{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T21:01:11Z","timestamp":1774558871340,"version":"3.50.1"},"reference-count":27,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"3","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Glob Oncol"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Exercise improves outcomes for patients with cancer, yet implementation of exercise counseling and referral in oncology care remains inconsistent in Latin America. This study evaluated current practices, barriers, promoters, and provider\/practice factors influencing exercise counseling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We conducted a cross-sectional survey in Spanish and Portuguese among oncology physicians in Latin America (December 2024-February 2025). Eligible participants included medical, surgical, radiation oncologists, and palliative care specialists providing direct patient care. A culturally adapted questionnaire assessed practices, barriers, promoters, and demographics. Analyses included descriptive statistics, Chi-square tests, and regression to examine predictors of counseling behaviors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      A total of 454 physicians completed the survey (response rate: 29.5%). Although 62.5% routinely assessed physical activity, only 26.4% did so at every visit. Half regularly recommended exercise (50.7%), and 27.1% never referred patients to exercise programs. Barriers included patient factors (eg, fatigue, side effects, low motivation), provider insecurity\/lack of knowledge (65.9%), and cultural norms favoring rest (76.7%). Promoters included prior training, personal exercise experience, and institutional support. Medical oncologists and hospital-based providers were more likely to assess, recommend, and refer (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .01). Regression showed prior training strongly predicted counseling behaviors (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), while years in practice was negatively associated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Despite awareness of exercise benefits, counseling and referral remain suboptimal in Latin America. Barriers include structural, knowledge, and cultural factors, while provider training and institutional support improve practices. These findings support the need for targeted educational, system investments, and culturally adapted guidelines to enhance exercise integration in cancer care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/go-25-00698","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T19:59:11Z","timestamp":1774555151000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Exercise Counseling and Referral Practices Among Oncology Care Physicians in Latin America: A Multinational Survey Study"],"prefix":"10.1200","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5770-324X","authenticated-orcid":true,"given":"Paulo Gustavo","family":"Bergerot","sequence":"first","affiliation":[{"name":"Oncoclinicas&amp;Co\u2014Medica Scientia Innovation Research (MEDSIR), Sao Paulo, Brazil"},{"name":"Hospital Santa Lucia, Brasilia, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0037-0303","authenticated-orcid":true,"given":"Cristiane Decat","family":"Bergerot","sequence":"additional","affiliation":[{"name":"Oncoclinicas&amp;Co\u2014Medica Scientia Innovation Research (MEDSIR), Sao Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1320-6708","authenticated-orcid":true,"given":"Errol J.","family":"Philip","sequence":"additional","affiliation":[{"name":"University of California Los Angeles, Los Angeles, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7254-3985","authenticated-orcid":true,"given":"Pamela Carvalho","family":"Muniz","sequence":"additional","affiliation":[{"name":"Oncoclinicas&amp;Co\u2014Medica Scientia Innovation Research (MEDSIR), Sao Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7034-0842","authenticated-orcid":true,"given":"Mar\u00eda Natalia Gandur","family":"Quiroga","sequence":"additional","affiliation":[{"name":"Division of Genitourinary Medical Oncology, \u00c1ngel H. Roffo Oncology Institute, Buenos Aires, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3114-0642","authenticated-orcid":true,"given":"Regina Barragan","family":"Carrillo","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cancerologia, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3116-912X","authenticated-orcid":true,"given":"Maria T.","family":"Bourlon","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cancerologia, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1647-2884","authenticated-orcid":true,"given":"Lucia","family":"Viola","sequence":"additional","affiliation":[{"name":"Fundacion Neumologica Colombiana, Bogota, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Morabito","sequence":"additional","affiliation":[{"name":"Dana-Farber Cancer Institute, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3312-3715","authenticated-orcid":true,"given":"Carolina Bernabe","family":"Ramirez","sequence":"additional","affiliation":[{"name":"Montefiore Einstein Comprehensive Cancer Center, Bronx, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1151-9903","authenticated-orcid":true,"given":"Gilberto","family":"Lopes","sequence":"additional","affiliation":[{"name":"University of Miami Sylvester Comprehensive Cancer Center, Miami, FL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1712-0848","authenticated-orcid":true,"given":"Sumanta K.","family":"Pal","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology &amp; Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7301-2163","authenticated-orcid":true,"given":"Enrique","family":"Soto-Perez-de-Celis","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, University of Colorado Anschutz Medical Campus, Denver, CO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7814-1773","authenticated-orcid":true,"given":"Narjust","family":"Florez","sequence":"additional","affiliation":[{"name":"Dana-Farber Cancer Institute, Boston, MA"},{"name":"Harvard Medical School, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2400-2935","authenticated-orcid":true,"given":"Kathryn H.","family":"Schmitz","sequence":"additional","affiliation":[{"name":"University of Pittsburgh, Pittsburgh, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"233","reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0b013e3181e0c112"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21591"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000002116"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.22.00687"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2024-109392"},{"key":"e_1_3_6_7_2","first-page":"840","article-title":"Exercising and immuno-oncology treatment (ExIO): A prospective pilot study for patients with solid tumors","volume":"32","author":"Bergerot PG","year":"2024","unstructured":"Bergerot PG, Bergerot CD, Silva JRG, et al: Exercising and immuno-oncology treatment (ExIO): A prospective pilot study for patients with solid tumors. Support Care Cancer 32:840, 2024","journal-title":"Support Care Cancer"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2502760"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11764-011-0208-4"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1200\/OP.21.00690"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/cnr2.1490"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.19.00124"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lana.2025.101147"},{"key":"e_1_3_6_14_2","first-page":"e-20220311","article-title":"Physical activity recommendations for cancer prevention and control: A Brazilian consortium","volume":"18","author":"Deminice R","year":"2022","unstructured":"Deminice R, Rezende LFM, Rosa DD, et al: Physical activity recommendations for cancer prevention and control: A Brazilian consortium. Braz J Oncol 18:e-20220311, 2022","journal-title":"Braz J Oncol"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccell.2020.10.013"},{"key":"e_1_3_6_16_2","article-title":"HOLA COVID-19 study group. HOLA COVID-19 study: Evaluating the impact of caring for patients with COVID-19 on cancer care delivery in Latin America","author":"Bernabe-Ramirez C","unstructured":"Bernabe-Ramirez C, Velazquez AI, Olazagasti C, et al: HOLA COVID-19 study group. HOLA COVID-19 study: Evaluating the impact of caring for patients with COVID-19 on cancer care delivery in Latin America. JCO Glob Oncol 10.1200\/GO.21.00251","journal-title":"JCO Glob Oncol"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-022-07342-6"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/ecc.12206"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2022.05.009"},{"key":"e_1_3_6_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-017-3640-9"},{"key":"e_1_3_6_21_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0227846"},{"key":"e_1_3_6_22_2","first-page":"e-3301","article-title":"Exercise as part of cancer care: Scientific evidences and the Brazilian context","volume":"33","author":"Deminice R","year":"2022","unstructured":"Deminice R: Exercise as part of cancer care: Scientific evidences and the Brazilian context. JPhysEduc 33:e-3301, 2022","journal-title":"JPhysEduc"},{"key":"e_1_3_6_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001122"},{"key":"e_1_3_6_24_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2302291"},{"key":"e_1_3_6_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5020"},{"key":"e_1_3_6_26_2","doi-asserted-by":"publisher","DOI":"10.1177\/02692155231170451"},{"key":"e_1_3_6_27_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.33245"},{"key":"e_1_3_6_28_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.32297"}],"container-title":["JCO Global Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/GO-25-00698","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T19:59:14Z","timestamp":1774555154000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/GO-25-00698"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":27,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1200\/GO-25-00698"],"URL":"https:\/\/doi.org\/10.1200\/go-25-00698","relation":{},"ISSN":["2687-8941"],"issn-type":[{"value":"2687-8941","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"2025-11-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-07","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e2500698"}}